NPIMap

Organization Active NPI

Residential Options, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Alton, IL
National Provider Identifier
1104047174
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
RESIDENTIAL OPTIONS, INC.
Practice address
4617 Wonderland Dr
Alton, IL 62002-7309
Phone
(618) 465-8845
Fax
(618) 463-4890
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Diane Tebbe
Title
VP
Phone
(618) 465-0044

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 0039123 IL

Addresses

Primary practice location

4617 Wonderland Dr
Alton, IL 62002-7309

Mailing address

4617 Wonderland Dr
Alton, IL 62002-7309
Phone (618) 465-8845

Other identifiers 1

IdentifierTypeStateIssuer
6013973OtherILPUBLIC HEALTH FACILITY ID

National Provider Directory

National Provider Directory
Tax ID family
Residential Options Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

4617 Wonderland Dr
Alton, IL 62002
Phone (618) 465-8845

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1104047174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4617 WONDERLAND DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620027309",
            "telephone_number": "618-465-8845",
            "fax_number": "618-463-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 WONDERLAND DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620027309",
            "telephone_number": "618-465-8845",
            "fax_number": "618-463-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL OPTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TEBBE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "618-465-0044"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IL",
            "license": "0039123",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUBLIC HEALTH FACILITY ID",
            "identifier": "6013973",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.